Publications
540 results found
Colledge A, Car J, Majeed A, 2008, Interventions for enhancing the skills of consumers to find, evaluate and use online health information, Cochrane Database of Systematic Reviews, ISSN: 1469-493X
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- Citations: 36
Civljak M, Koshy E, Marlais M, et al., 2008, Internet-based interventions for smoking cessation, Cochrane Database of Systematic Reviews, ISSN: 1469-493X
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- Citations: 139
Koshy E, Car J, Majeed A, 2008, Effectiveness of mobile-phone short message service (SMS) reminders for ophthalmology outpatient appointments: Observational study, BMC Ophthalmology, Vol: 8, Pages: 1-6, ISSN: 1471-2415
BackgroundNon-attendance for hospital outpatient appointments is a significant problem in many countries. It causes suboptimal use of clinical and administrative staff and financial losses, as well as longer waiting times. The use of Short Message Service (SMS) appointment reminders potentially offers a cost-effective and time-efficient strategy to decrease non-attendance and so improve the efficiency of outpatient healthcare delivery.MethodsAn SMS text message was sent to patients with scheduled appointments between April and September 2006 in a hospital ophthalmology department in London, reminding them of their appointments. This group acted as the intervention group. Controls were patients with scheduled ophthalmology appointments who did not receive an SMS or any alternative reminder.ResultsDuring the period of the study, 11.2% (50/447) of patients who received an SMS appointment reminder were non-attenders, compared to 18.1% (1720/9512) who did not receive an SMS reminder. Non-attendance rates were 38% lower in patients who received an SMS reminder than in patients who did not receive a reminder (RR of non-attendance = 0.62; 95% CI = 0.48 – 0.80).ConclusionThe use of SMS reminders for ophthalmology outpatient appointments was associated with a reduction of 38% in the likelihood of patients not attending their appointments, compared to no appointment reminder. The use of SMS reminders may also be more cost-effective than traditional appointment reminders and require less labour. These findings should be confirmed with a more rigorous study design before a wider roll-out.
Black A, Car J, Majeed A, et al., 2008, Strategic considerations for improving the quality of eHealth research: we need to improve the quality and capacity of academia to undertake informatics research., Inform Prim Care, Vol: 16, Pages: 175-177, ISSN: 1476-0320
Car J, Ng C, Atun R, et al., 2008, SMS text message healthcare appointment reminders in England., J Ambul Care Manage, Vol: 31, Pages: 216-219, ISSN: 0148-9917
Missed appointments place a costly and disruptive strain on National Health Service resources in England. One major source of missed appointments appears to be insufficient communication between patients and providers. SMS text messaging shows promise as a simple, cost-effective means of bridging this communications gap. SMS provides an instant and asynchronous means of communication that protects patient privacy. The potential for this technology is balanced, however, by the lack of high-quality evidence to support its use. There is an urgent need for robust evaluation of critical quality, safety, cost implications, and acceptability before the large-scale rollout of SMS-based systems.
Raby A, Car J, Kong WM, 2008, Type 2 diabetes: follow up., London J Prim Care (Abingdon), Vol: 1, Pages: 10-11, ISSN: 1757-1472
A 41 year old accountant recently registered with your practice. His registration health check indicates: BMI 31, BP 150/95, urine 1 + of glucose, no protein, smoker of 15 cigarettes daily. He has had diabetes for seven years and is taking Metformin 500 mg four times daily. It has been over a year since he last saw a doctor and he has now come to see you to obtain a prescription for medication.
Upadhyay N, Kokalj Kokot M, Kokalj Kokot M, et al., 2007, Mobile phone messaging - A telemedicine for people with diabetes mellitus, Cochrane Database of Systematic Reviews, ISSN: 1469-493X
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- Citations: 5
Patel H, Bell D, Molokhia M, et al., 2007, Trends in hospital admissions for adverse drug reactions in England: analysis of national hospital episode statistics 1998-2005, BMC Clinical Pharmacology, Vol: 7, Pages: 9-9, ISSN: 1472-6904
BACKGROUND: Adverse drug reactions (ADRs) are a frequent cause of mortality and morbidity to patients worldwide, with great associated costs to the healthcare providers including the NHS in England. We examined trends in hospital admissions associated with adverse drug reaction in English hospitals and the accuracy of national reporting. METHODS: Data from the Hospital Episode Statistics database (collected by the Department of Health) was obtained and analysed for all English hospital episodes (1998-2005) using ICD-10 codes with a primary (codes including the words ('drug-induced' or 'due to') or secondary diagnosis of ADR (Y40-59). More detailed analysis was performed for the year 2004-2005 RESULTS: Between 1998 and 2005 there were 447 071 ADRs representing 0.50% of total hospital episodes and over this period the number of ADRs increased by 45%. All ADRs with an external code increased over this period. In 2005 the total number of episodes (all age groups) was 13,706,765 of which 76,692 (0.56%) were drug related. Systemic agents, which include anti-neoplastic drugs, were the most implicated class (15.7%), followed by analgesics (11.7%) and cardiovascular drugs (10.1%). There has been a 6 fold increase in nephropathy secondary to drugs and a 65% decline in drug induced extra-pyramidal side effects. 59% of cases involving adverse drug reactions involved patients above 60 years of age. CONCLUSION: ADRs have major public health and economic implications. Our data suggest that national Hospital Episode Statistics in England have recognised limitations and that consequently, admissions associated with adverse drug reactions continue to be under-recorded. External causes of ADR have increased at a greater rate than the increase in total hospital admissions. Improved and more detailed reporting combined with educational interventions to improve the recording of ADRs are needed to accurately monitor the morbidity caused by ADRs and to meaningfully evaluate national initia
Freeman GK, Woloshynowych M, Baker R, et al., 2007, Continuity of care 2006: What have we learned since 2000 and what are policy imperatives now? Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation R & D (NCCSDO).
Srishanmuganathan J, Patel H, Car J, et al., 2007, National trends in the use and costs of anti-obesity medications in England 1998-2005, JOURNAL OF PUBLIC HEALTH, Vol: 29, Pages: 199-202, ISSN: 1741-3842
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- Citations: 14
Millett C, Car J, Eldred D, et al., 2007, Diabetes prevalence, process of care and outcomes in relation to practice size, caseload and deprivation: national cross-sectional study in primary care, JOURNAL OF THE ROYAL SOCIETY OF MEDICINE, Vol: 100, Pages: 275-283, ISSN: 0141-0768
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- Citations: 57
Car J, Millett C, Khunti K, et al., 2007, Diabetes prevalence, process of care and outcomes in relation to practice size, caseload and deprivation: national cross-sectional study in primary care, DIABETIC MEDICINE, Vol: 24, Pages: 78-78, ISSN: 0742-3071
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- Citations: 1
Saxena S, Misra T, Car J, et al., 2007, Systematic review of primary health care interventions to improve diabetes outcomes in minority ethnic groups, DIABETIC MEDICINE, Vol: 24, Pages: 62-63, ISSN: 0742-3071
Patel H, Srishanmuganathan J, Car J, et al., 2007, Trends in the prescription and cost of diabetic medications and monitoring equipment in England 1991-2004, DIABETIC MEDICINE, Vol: 24, Pages: 69-69, ISSN: 0742-3071
Patel H, Srishanmuganathan J, Car J, et al., 2007, Trends in the prescription and cost of diabetic medications and monitoring equipment in England 1991-2004, JOURNAL OF PUBLIC HEALTH, Vol: 29, Pages: 48-52, ISSN: 1741-3842
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- Citations: 15
Car J, Patel H, Srishanmuganathan J, et al., 2007, Diabetes care in developing countries, CANADIAN MEDICAL ASSOCIATION JOURNAL, Vol: 176, Pages: 209-212, ISSN: 0820-3946
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- Citations: 2
Patel H, Srishanmuganathan J, Car J, et al., 2007, Trends in the prescription and cost of diabetic medications and monitoring equipment in England 1991-2004, Journal of Public Health, Vol: 29, Pages: 48-52, ISSN: 1741-3842
Background: To report the trend in prescriptions and cost of antidiabetic drugs and glucose monitoring equipment in England from 1991 to 2004. Methods: We analysed data on all community antidiabetic drug prescriptions in England collated from the Prescription Cost Analysis system. Results: The total number of diabetes prescriptions (medicines and monitoring) rose from 7613000 (1991) to 24325640 (2004) (>300% increase). Meanwhile, total costs increased by 650%. Insulins are the biggest contributor to cost followed by monitoring equipment and then oral medications. Three times as many items of oral tablets are prescribed than insulins. Metformin accounts for 40% of all diabetic drug dispensations but only 7% of the costs. More is spent on glitazones now than on either metformin or sulphonylureas. Conclusions: There has been a substantial increase in the cost of managing diabetes in the community. Costs are likely to continue to rise in the future, as the prevalence of diabetes increases and through more aggressive identification and management of patients with diabetes in the hope of reducing the even more costly complications. The cost implications of glucose monitoring merits further study. © The Author 2006, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.
Saxena S, Misra T, Car J, et al., 2007, Systematic review of primary healthcare interventions to improve diabetes outcomes in minority ethnic groups., J Ambul Care Manage, Vol: 30, Pages: 218-230, ISSN: 0148-9917
OBJECTIVES: To systematically review the effectiveness of primary care interventions on glycaemic control and cardiovascular risk factors in minority ethnic groups with diabetes. RESEARCH DESIGN AND METHODS: We searched electronic databases, the Cochrane Library, and research registers to December 2006, using multiple search terms related to ethnicity and diabetes. We examined bibliographies of retrieved articles and corresponded with authors. We included randomized controlled trials, controlled clinical trials, and cohort studies. Two reviewers independently assessed study eligibility and quality. RESULTS: Nine studies including 2565 patients met our inclusion criteria. Two main models of care were identified: (1) case management, with specialist diabetes nurses and community health workers and (2) the use of the services of link workers from minority ethnic groups to guide people with diabetes. Heterogeneity of the studies prevented us from carrying out a meta-analysis. Case management improved glycaemic control (reduction in HbA1c range -0.5% to -1.75%). Small but statistically significant reductions in other cardiovascular risk factors were reported with both models. CONCLUSIONS: In minority ethnic groups with diabetes, case management improves glycaemic control and cardiovascular risk factors and link workers improve cardiovascular risk factor control. However, their relative effectiveness, cost, and sustainability of changes over time warrant further evaluation.
Saxena S, Car J, Eldred D, et al., 2007, Practice size, caseload, deprivation and quality of care of patients with coronary heart disease, hypertension and stroke in primary care: national cross-sectional study, Vol: 7
BACKGROUND: Reports of higher quality care by higher-volume secondary care providers have fuelled a shift of services from smaller provider units to larger hospitals and units. In the United Kingdom, most patients are managed in primary care. Hence if larger practices provide better quality of care; this would have important implications for the future organization of primary care services. We examined the association between quality of primary care for cardiovascular disease achieved by general practices in England and Scotland by general practice caseload, practice size and area based deprivation measures, using data from the New General Practitioner (GP) Contract. METHODS: We analyzed data from 8,970 general practices with a total registered population of 55,522,778 patients in England and Scotland. We measured practice performance against 26 cardiovascular disease (coronary heart disease, left ventricular disease, and stroke) Quality and Outcomes Framework (QOF) indicators for patients on cardiovascular disease registers and linked this with data on practice characteristics and census data. RESULTS: Despite wide variations in practice list sizes and deprivation, the prevalence of was remarkably consistent, (coronary heart disease, left ventricular dysfunction, hypertension and cerebrovascular disease was 3.7%; 0.45%; 11.4% and 1.5% respectively). Achievement in quality of care for cardiovascular disease, as measured by QOF, was consistently high regardless of caseload or size with a few notable exceptions: practices with larger list sizes, higher cardiovascular disease caseloads and those in affluent areas had higher achievement of indicators requiring referral for further investigation. For example, small practices achieved lower scores 71.4% than large practices 88.6% (P < 0.0001) for referral for exercise testing and specialist assessment of patients with newly diagnosed angina. CONCLUSION: The volume-outcome relationship found in hospital settings is not
Khunti K, Car J, Majeed A, 2006, Quality of diebetes care in England: results of the Quality and Outcomes Framework for primary care, Practical Diabetes International, Vol: 23, Pages: 379-380
Chada P, Car J, 2006, Identifying and treating UTIs, Independent Nurse, Pages: 26-26
Sokol DK, Car J, 2006, Patient confidentiality and telephone consultations: time for a password, JOURNAL OF MEDICAL ETHICS, Vol: 32, Pages: 688-689, ISSN: 0306-6800
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- Citations: 15
van Baar JD, Joosten H, Car J, et al., 2006, Understanding reasons for asthma outpatient (non)-attendance and exploring the role of telephone and e-consulting in facilitating access to care: exploratory qualitative study, QUALITY & SAFETY IN HEALTH CARE, Vol: 15, Pages: 191-195, ISSN: 1475-3898
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- Citations: 36
Sokol D, Car J, 2006, Protecting patient confidentiality in telephone consultations in general practice, BRITISH JOURNAL OF GENERAL PRACTICE, Vol: 56, Pages: 384-385, ISSN: 0960-1643
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- Citations: 13
Car J, 2006, BMJ learning - Urinary tract infections in women: diagnosis and management in primary care, BMJ-BRITISH MEDICAL JOURNAL, Vol: 332, Pages: 94-97, ISSN: 0959-535X
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- Citations: 57
McKinstry B, Ashcroft RE, Car J, et al., 2006, Interventions for improving patients' trust in doctors and groups of doctors, COCHRANE DATABASE OF SYSTEMATIC REVIEWS, ISSN: 1469-493X
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- Citations: 40
Misra T, Saxena S, Car J, et al., 2006, What can primary care do to improve health outcomes in diabetes and cardiovascular disease for ethnic minority groups in the UK?, London, Publisher: Report for United Health Europe
Car J, 2005, Exploring notions of patient-doctor partnership in South Asian and European people with asthma : qualitative interview study.
Kersnik J, Car J, Švab I, 2005, Management of chronic low back pain in family practice, Zdravstveno varstvo, Vol: 44, Pages: 193-198
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